Mental Health Services Utilization and Costs of Patients with Schizophrenia in Three Areas of Spain

Background: The analysis of the costs of schizophrenia and its treatment under different mental health care structures will facilitate the improved allocation of the limited resources available for the treatment of schizophrenia. The research we present compares health services use and total health care costs of three cohorts of patients with schizophrenia which are representative of three areas of Spain (Burlada in Navarra, Cantabria and the Eixample of Barcelona). Methods: Cases selected were those first time contacts with any psychiatric service that received a diagnosis of schizophrenia. Patients were evaluated in the third year after onset. Results: The mean number of outpatient visits per patient per year was 10.7 and the mean inpatient days were 9.5. The mean direct costs per patient in the third year of treatment was 295.459 Spanish pesetas. Conclusions: Costs were greater in the two centers with larger community mental health development. Barcelona has the higher cost per patient (368.440 PTA) and Cantabria the lowest cost. We did not find that this cost difference turned into a better outcome. Costs of patients with better functional status were lower than costs of patients with a worse outcome. Some of the findings may be explained by service availability.